Subcutaneous emphysema, surgical emphysema, or tissue space emphysema are different names for a similar condition, namely, the abnormal presence of air in tissue spaces Subcutaneous emphysema occurs rarely during dental procedures. When it does occur, it can be a frightening experience that often will be confused with an anaphylactic reaction.
Differentiating the two conditions is not difficult. Palpation of the swollen head and neck areas will elicit crepitus, or a ‘Velcro’ sensation, that is not present in anaphylaxis. Anaphylaxis occurs after exposure to an allergen that elicits an IgE-mediated hypersensitivity that leads to an abrupt onset of symptoms that may include pruritis of lips, tongue and palate; oedema of the lips; nausea; vomiting; dysponea; wheezing; rhinorrhoea; syncope and hypotension.
Anaphylaxis is a true medical emergency, whereas subcutaneous emphysema is generally not life-threatening.
Therapy for subcutaneous emphysema involves the following: (i) correct diagnosis and (ii) antibiotic antibiotic therapy. Subcutaneous air will resolve over time; therefore, observation is indicated
Complications may rarely include cardiac tempanade, airway compromise, or air embolism.